Community nursing plays an important role in supporting residents’ complex healthcare needs, with new initiatives such as telehealth, dental and mental health.

As Singapore shifts its healthcare focus from disease treatment to prevention, more new community nursing services have been rolled out to residents in the south-east region to help them age well and live independently at home.

Singapore General Hospital (SGH) Community Nurses, an increasingly important group in population health management, are stationed at 35 neighbourhood Community Nurse Posts (CNPs). The programme started in 2018, with the nurses focusing on helping the elderly with their chronic disease management, including health assessment and monitoring, medication selfmanagement, and care referral.

“As part of the initiatives in supporting seniors who are well or at pre-frail stage, community nurses provide health coaching in preventive health to empower seniors to look after their own health,” said Ms Cui Xue, Senior Staff Nurse, Population Health and Integrated Care Office (PHICO) – Community Nursing, SGH.

More recently, however, the roles of community nurses have expanded and they are supporting younger populations in their 40s and 50s, as well as residents with diseases requiring palliative and supportive care, mental health and oral health support, said Ms Nur Fadillah Ahmad, Senior Staff Nurse, PHICO – Community Nursing, SGH.

Some of the new services available to residents are Community Outpatient Antibiotic Therapy (COPAT) and post-chemotherapy granulocyte-colony stimulating factor (G-CSF) injections for cancer patients. These are treatments usually administered in hospitals or outpatient clinics, so having them done at home helps patients avoid hospitalisation or incur other charges. “They also feel more comfortable at home,” said Ms Cui.

Under COPAT, patients who are in stable condition can undergo a course of intravenous antibiotics treatment by a community nurse at home instead of in the hospital. These treatments last from days to weeks. For G-CSF injections, patients or caregivers are taught to perform the injections competently. “We will go to their homes to supervise and help them gain greater confidence in injecting themselves,” said Ms Cui, noting that if they are unable to do so, they will need to go to the National Cancer Centre Singapore (NCCS), private home nursing services or nearby clinics for the injections 24 hours after their chemotherapy.

The community nursing team also collaborates with National Dental Centre Singapore (NDCS) on an ongoing pilot to conduct oral health screening and education for seniors. The aim is for seniors to have at least 20 natural teeth when they reach 80 years of age.

“Poor oral health can lead to conditions such as gum disease and tooth decay, both of which can result in tooth loss if left untreated. Extensive tooth loss can impair a person’s chewing ability and may lead to malnutrition in the long run, especially in the elderly,” said Dr Chan Pei Yuan, Consultant, Clinical - Restorative Dentistry, NDCS, adding that oral health awareness is still lacking in Singapore, with many people visiting the dentist only when there is pain, instead of the recommended six-monthly preventive visits.

Forming a network with hospitals, polyclinics and private clinics is also essential if residents, in particular the elderly, are to access healthcare resources easily. Community nursing already taps on the resources of voluntary welfare agencies like Thye Hua Kwan, NTUC Health and Montfort Care, whose social workers help residents who need financial and social services.

Even as more schemes are being made available, many are unaware or unfamiliar with what they are and how community nurses can help them. The first step is for people to visit and register with their nearest CNP or Active Ageing Centre (AAC). They can then seek the help of these support services when required.

“Moving forward, we will be moving beyond care for the elderly population to other populations with different care needs,” said Ms Cui.

The good news is that this broad shift will reach out to more people in the community and improve healthcare accessibility. Importantly, residents will be healthier and less dependent on acute care resources.

With community nurses extending their reach into maternal and child care in future, these community services by both the nurses and AACs will eventually become a one-stop holistic healthcare service centre for residents.


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